A birth plan is simply a written description of your priorities and preferred options during labor and birth and afterward. The plan may be placed in your chart, where those involved in your care can read and consult it. The portion that pertains to the care of your baby (the baby care plan) can be placed in the baby's chart, which is separate from your own.
A birth plan has many advantages. Simply preparing a birth plan helps you focus your preparation on the various options (for example, natural versus medicated childbirth, circumcision versus no circumcision, breast- versus bottle-feeding). It encourages you and your partner to discuss your worries and expectations, and to come to agreement on what is important. During labor, of course, the benefit of the birth plan is that you do not have to take the time and trouble to tell each staff member your wishes on every option as it comes up.
Birth plans also help your caregiver. If you prepare a rough draft and go over it with your caregiver, he or she will learn more about you as well as your preferences and will know how to help you in labor. He or she can also help you modify options that may seem unwise or inappropriate. Potential misunderstandings can be detected in advance, so that neither of you is caught by surprise when the stress of labor makes discussion difficult. Your caregiver may be willing to initial your plan, indicating to hospital staff that he or she agrees with it. It is not a legal agreement or a contract. It is simply a statement of your wishes.
For the nursing staff and other people who will be caring for you during labor, the birth plan makes you less of a stranger to them. It is a shortcut to communication and lets them know what is important to you and how they can help.
Your birth plan should be flexible, taking into account not only a normal, or textbook, labor but also the possibility of a difficult labor, complications, or other unexpected events.
Components of the Birth Plan
A birth plan helps you communicate your wishes to your caregivers help for the staff to know that. If you have a fear of hospitals or medications, or if you have had unpleasant experiences in hospitals in the past, tell them. If a natural birth is extremely important to you, let them know so they can offer you maximum support in that effort.
If avoidance of pain is a high priority, let them know. Inform the staff if you have religious preferences, impaired hearing or vision, or if this has been a difficult pregnancy. Knowledge of these conditions will help the staff meet your needs. You might simply state that you will appreciate their help, advice, and expertise.
The next section of the birth plan is a straightforward list of your preferences for a normal labor and birth. Include only items that you care about. You do not have to hold an opinion on everything. At the moment, you may feel you do not have enough background to decide your preferences on these procedures. Childbirth classes and discussions with your caregiver will give you the needed information.
If your labor is prolonged or more painful than expected, if the baby isn't tolerating labor, or if you develop complications that make intervention necessary, your ideal birth plan may have to change. It should reflect a recognition that these events can occur and you are flexible enough to accept changes in the plan if they are necessary for your sake or your baby's.
Sometimes a cesarean birth becomes necessary for any of a number of reasons. It helps if you acknowledge the possibility of a cesarean birth in your birth plan, and indicate your preferences if it becomes necessary. For example, you might state that you prefer to remain awake, to have your husband present, or to touch and nurse your baby as soon as possible after the surgery.
Unexpected Loss of a Baby
One of the greatest difficulties we face is the possibility that the baby may not live. Every prospective parent worries at times about losing a child. Although it is uncommon, some babies die. This very sad ending to the pregnancy leaves the parents stunned, grieving, depressed, and angry. After losing a child, parents are in no state to make important decisions. If you have thought through how you would want a newborn death handled, then, should a death occur, such decisions will have already been made by you at a time when you were calm.
Many counselors recommend that couples have private time together with their baby who died. Seeing or holding the child gives the parents a chance to say good-bye to the baby. In addition, pictures, footprints of the baby, and perhaps a lock of hair are mementos that mean a great deal later.
Having a memorial service or a funeral for the baby allows friends and relatives to also acknowledge the baby's life and death. Formal ceremonies can often give family and friends a way to express their grief and their support for the parents.
The question of an autopsy often comes up. If the cause of death is unclear, sometimes an autopsy is beneficial, both in answering questions and in possibly preventing the death of another baby in the future. It would be worthwhile to think through in advance whether you would consent to an autopsy in such a case.
The Value of a Birth Plan
A birth plan represents your thinking regarding normal labor, postpartum, and newborn care. It also includes your preferences if the process does not follow a normal course. Because you prepare it when you are calm and rational, it reflects what you really desire. It becomes a valuable guide for you and for your caregivers during a stressful period when you might not be thinking clearly.